Sunday, November 22, 2015

Ream and Run - state of the art

Due to the rapidly increasing interest world-wide in the ream and run procedure - the radically conservative approach to shoulder joint replacement for active individuals - we've assembled a readers' guide to all blog posts on this procedure. Just click on the underlined subject to open the link.

Here is a recent summary of the practice and results of the ream and run (see this link).

Below are the x-rays from a patient two years after the ream and run showing the absence of a plastic (polyethylene) glenoid prosthesis, the absence of bone cement (polymethymethacrylate), the use of impaction grafting to fix a relatively thin stem in the humerus, and the presence of a fibrocartilagenous space that has grown between the humeral head and the reamed glenoid bone.


Update: We've performed over 600 ream and run procedure on patients ranging from 21 to 81 years of age (average 57 ± 9 years). 92 % of the patients were male. The distribution of the diagnoses are shown in the pie chart below
Before surgery these patients could perform an average 4.7 of the twelve functions of the Simple Shoulder Test (SST). The percentage of patients able to perform each of the SST functions before surgery is shown below.

Ream and Run - research and development
How the shoulder works

Ream and Run for Shoulder Arthritis - Genesis
Shaping the arthritic socket
Comparison to total shoulder

Considerations regarding the ream and run
The ream and run - a glenohumeral arthroplasty that avoids the risks of plastic glenoid components
Shoulder replacement for active people video 1
Shoulder replacement for active people video 2
The Ream and Run Essentials
From where do our shoulder joint replacement patients come?
Shoulder arthritis consultation for those who live away from Seattle
What is shoulder arthritis?
Shoulder arthritis - what you should know about it.
What are the types of shoulder arthritis?
How is the diagnosis of shoulder arthritis made?
The arthritic glenoid - evaluation and management
Is the shoulder arthritic or frozen?
Is the shoulder stiff?
Why do arthritic shoulders get stiff?
Assessing shoulder limitations - the Simple Shoulder Test
Shoulder limitations in Degenerative Joint Disease of the Shoulder
What can be done for shoulder arthritis without surgery?
When is it time for a shoulder replacement?
When is it the right time for a shoulder replacement for arthritis?
Shoulder joint replacement - special considerations
A ream and run is not the same as a hemiarthroplasty
Patient factors that can influence the outcome of surgery
Considerations in treating shoulder arthritis in patients under 50 years of age
Shoulder arthritis - a vicious circle
Shoulder joint replacement for arthritis - when is the right time to have surgery? FAQ
The ream and run for shoulder arthritis - commonly asked questions - from a weight lifter
Shoulder Arthritis: The Cliff Notes for Physical Therapists and Other People
Shoulder joint replacement - many different types of arthritis
Can the glenoid be reamed after a biological resurfacing?
The ream and run and the kiss sign - the contribution of an intact labrum to the suction cup effect

X-ray Evaluation
Guide to shoulder x-rays for arthritis
Shoulder joint replacement arthroplasty - x-ray evaluation
The Axillary view = the 'truth' view
The axillary - truth - view. It tells us what we need to know about arthritis.
The Walch B2 glenoid in a young active person - a recurrent theme.
Classifying glenoid morphology with axillary views and CT scans - comparable reliability
The Bad Arthritic Triad - BAT - the biconcave glenoid and its management
The relationship of glenoid version to stability in shoulder arthritis, the bad arthritic triad
Humeral subluxation in arthritic shoulders
Being physically active makes your body function more like a young person’s.
Patients taking narcotics before surgery often have poorer results from surgery
Medications and joint replacement
Interscalene brachial plexus block vs. general anesthesia

Factors affecting the outcome
Use of a ream and run to manage the bad arthritic triad without changing glenoid version.
Ream and run for severe glenoid deformity
Ream and run with RIP and eccentric head for a B1 glenoid seen on a standardized axillary view
Ream and run for the B2, retroverted glenoid
Ream and run for the posteriorly eroded type B2 glenoid with posterior humeral displacement
Ream and run with eccentric head and rotator interval plication for glenohumeral arthritis
Shoulder arthritis with posterior humeral subluxation managed with the ream and run
The ream and run in the face of severe posterior glenoid erosion
Ream and run for shoulder arthritis with a posteriorly subluxated humeral head
Humeral arthroplasty - does the entry point matter?
Ream and Run for Capsulorrhaphy Arthropathy - two recent cases
Ream and run for severe post fracture deformity
Managing a humeral shaft deformity with a stemmed humeral component
How we do a biceps tenodesis with shoulder arthroplasty?

Patient-specific instrumentation
Another ream and run diary!
Ream and run: "commit 100% to rehab": two year followup
Shoulder function two years after ream and run: persistence, pool, patience
Ream and run - ultimate rehabilitation
Ream and run - patient observations at four years after the procedure for the bad arthritic triad
Extraordinary rehabilitation effort after a bilateral ream and run procedure
Ream and run and stiffness - prevention and treatment - manipulation and surgical release 
Antibiotics after joint replacement

Cartilage regrowth after the ream and run in an 81 year old farmer
Ream and Run - x-rays at 4+ years in a swimmer
Ream and run for the triad of biconcavity, retroversion and posterior humeral subluxation
Ream and run shoulder arthroplasty - results from Texas
Hockey after ream and run
Ream and run for B2 glenoid - back to active duty in our armed forces
Ream and run in patients under 55 years
First woman in the world to get 8th degree black belt in Shotokan Karate
2.5 years after ream and run: martial arts, horsemanship, weight training
Propionibacterium periprosthetic infections of hip, knee and shoulder
An unusual course after a ream and run with a happy ending.

To see a YouTube video on how the ream and run is done, click on this link.

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How you can support research in shoulder surgery Click on this link.

We have a new set of shoulder youtubes about the shoulder, check them out at this link.

Be sure to visit "Ream and Run - the state of the art" regarding this radically conservative approach to shoulder arthritis at this link and this link

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You may be interested in some of our most visited web pages  arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'